Table 3.
Overview of characteristics of intervention studies.
| Author, year (country) | Design & Follow-up time | Brief intervention description and comparator (if available) | Sample size at recruitment (% follow-up) | Physical activity outcome measure(s) used | Mean age of residents (SD) | Key findings relating to physical activity | Level of social–ecological model addressed [1,2] |
|---|---|---|---|---|---|---|---|
| Arrieta et al., 2018 [58] (Spain) | 2 Arm, multicentre RCT; 3- and 6-month follow-up | Intervention: Multicomponent exercise program; control group: routine activities offered by study care homes | 112 (82%) | Accelerometer (Actigraph GT3X) | 84.9 (DS 6.9) | Increase in LPA (+5.2) and in the number of steps taken + 141). However, this did not reach statistical significance | Intrapersonal |
| Chin et al., 2006 [62] (Netherlands) | 4 arm RCT; 6-month follow-up | Intervention: Arm 1: Resistance training; Arm 2: Functional-skills training; Arm 3: Resistance training & functional skills training; Control: Group discussion (placebo) | 157 (70%) | Accelerometer (MTI model 7164); LASA Physical Activity Questionnaire | 82 (SD 7.5) | No significant difference between the groups on habitual PA as measured over 3 consecutive days; reduction in moderate intensity PA in the intervention group (-12.2 min, 95% CI:-23.8 to 0.7) at 6 months | Intrapersonal |
| Forster et al., 2021 [78] (UK) | 2 arm cluster RCT; 3-, 6-, 9-follow-up | MoveMore: a whole home intervention involving care home staff designed to encourage and support PA in care home residents | 153 (74%) | Accelerometer (Actigraph GT3X) | 86.4 (SD 7.0) | There was no suggestion of a difference between the arms at 9 months, this equates to an average increase in time spent in any intensity of PA of 18 min in the MoveMore arm (10.9% of accelerometer wear time) and 7 min in the UC arm (12.6% of accelerometer wear time) | Intrapersonal, interpersonal, organisational, policy |
| Galik et al., 2008 [69] (USA) | Single group, repeated measures; 6-month follow-up | Motivational intervention: the Restorative Care Intervention for the Cognitively Impaired (Res-Care-CI) | 46 (not reported) | Accelerometer (Actigraph); Physical Activity Survey in Long Term Care (PAS-LTC) | 83 (SD 8.8) | No overall significant change in PA reported in PAS-LTC (F = 0.931, p = 0.43; significant decrease in PA measured by accelerometer in 35 residents (F = 4.93, p = 0.005) at 6 months. 95% CI not reported. | Intrapersonal; interpersonal |
| Galik et al., 2014 [63] (USA) | Cluster RCT (4 clusters); 6-month follow-up | Intervention: Function focussed care; Control: Not specified | Residents: 103(100%); Nursing assistants: 77 (not given) | Accelerometer (Actigraph); Physical Activity Survey in Long Term Care (PAS-LTC) | 84 (SD 9.9) | Significant improvement over 24 hr in intervention group at 6 months on PAS-LTC: 74.33 mins (SE = 14.75) vs. 126.05 min, p = 0.01. and activity counts: 32 845 (SE = 7221) vs. 86 288 (SE = 26 684), p = 0.05. 95% CI not reported. | Intrapersonal; interpersonal; policy; perceived physical environment |
| Galik et al., 2021 [59] (USA) | Cluster RCT (12 clusters); 4-month and 12-month follow-up | Intervention: Function and behaviour focussed care (policy and environment assessment, education and training, goal setting, nursing home staff training); control: educational component only of Function and behaviour focussed care intervention | 336 (67%) | Accelerometer (Actigraph); Physical Activity Survey in Long Term Care (PAS-LTC) | 82.6 (SD 10.1) | There was a significantly greater increase in time spent in total activity (p = 0.004), moderate activity (p = 0.012), light activity (p = 0.002), and a decrease in resistiveness to care (p = 0.004) in the treatment versus control group at 4 months, but not at 12 months. | Intrapersonal; interpersonal; organisational; Policy; perceived physical environment |
| Grönstedt et al., 2013 [64] (Scandinavia) | RCT; 3-month follow-up | Intervention: Multicomponent (Goal setting, physical exercise, training in activities of daily living, staff education | 322 (83%) | Nursing Home Life Space Diameter | 85 (SD 7.8) | Significant increase in PA level in intervention group over 2-week period (p = 0.038). 95% CI not reported. | Intrapersonal |
| Hurley et al., 2020 [68] (UK) | Quasi-experimental feasibility pre-test–post-test; 8 month follow-up | Personalised care plan with physical activities tailored for each resident. Report prepared to suggest changes to working practices, and the physical environment to encourage PA | 35 (Not given) | APA (Assessment of physical activity); PAL (Pool activity checklist) | 89 (SD 6.8) | Compared to baseline of 3.56, participant’s engagement with activity increased after intervention to 3.21 (change from baseline − 0.4; 95%CI − 0.72 to − 0.07), but returned to baseline values at 8-months at 3.63 (change − 0.03; 95%CI − 0.35 to 0.29). No data provided on APA |
Intrapersonal; interpersonal; organisational; policy; perceived environment |
| Keogh et al., 2014 [73] (Australia) | 2 Group, Quasi-experimental pre-test–post-test; 1-week follow-up | Intervention: Exercise games (Nintendo Wii Sports); Control: usual care | 34 (76%) | Rapid Assessment of Physical Activity Questionnaire | 83 (SD 7.0) | Significant improvement in self-reported PA in intervention group: p = 0.009, effect size d = 1.19 ± 0.71. 95% CI not reported. | Intrapersonal |
| Koeneman et al., 2017 [76] (Netherlands) | Exploratory field study − 2 Group Randomised block design; 3-month follow-up | Intervention: Descriptive norm information via devised “news reports” about older people participating in PA and images of older adults engaging in PA. Control group: descriptive norms conveying images and accounts of inactive older adults. | 21 ( not given) | Self-reported participation in organised PA activities | 87 (SD 3.6) | In the control group 2 (22%) participants had taken part in one or more PA related activities versus 8 (80%) participants in the experimental group (Fisher’s exact test, p = 0.027, two-sided) | Intrapersonal |
| Liu and Hu, 2015 [70] China | 1 Group Quasi-experimental pre-test–post-test; 1-month follow-up | Intervention: Multicomponent 6 week Go4Life program (exercise guides, goal setting, daily activities); Control: no control group | 39(87%) | International Physical Activity Questionnaire | 76 (SD 4.2) | Significant improvement in PA post-test: 117.21 (SD 53.2) vs. 240.15 (SD 106.96) mins/week: F = 82.93, ==0.01. 95% CI not reported. | Intrapersonal |
| Lobo et al., 2010 [71] (Portugal) | 3 arm prospective longitudinal study with experimental design; 15-month follow-up | 4 groups; Interventions: Aerobic training (AT) or strength training (ST) or health education (HE); Control: usual care | 185(75%) | Accelerometer (Actigraph) | 78 (SD 6.9) | Significant improvement in PA in AT (10 915 ± 7112 counts/hour vs. 17 761 ± 8218 counts/hour, p < 0.5) and ST 10 915 ± 7112 vs. 17, 053 ± 5519, p < 0.5) groups. Improvement in PA in HE group (10 915 ± 7112 vs 13 933 ± 6902) but not significant. 95% CI not reported. | Intrapersonal |
| Mouton et al., 2017 [75] (Belgium) | Two arm quasi-experimental 3-month follow-up | Intervention: giant exercising board game | 21 (81%) | ActiGraph GT3X+, Actigraph LLC, Pensacola, FL, USA | 86.2 (SD 1.75) | In the intervention group, significant increases of 437 (+14.9%, p = 0.04) and 1162 (+39.8%, p = 0.03) steps/day were observed after the intervention and the follow-up period, respectively. Average steps per day in the control group decreased significantly after the intervention (−817, −24.1%, p = 0.02), but not after the follow-up period (−280, −8.3%, p = 0.22). | Intrapersonal |
| Moyle et al., 2018 [67] (Australia) | Three-arm cluster RCT. 5, 10, 15 weeks post-intervention | Control group: usual care. Intervention group one: Plush toy. Intervention group 2: PARO therapeutic robot | 459 (99%) | Sensewear Professional 8.0 activity armband (Temple Healthcare, BodyMedia Inc) | 86 (7.5) | At 10 weeks, the PARO group showed a greater reduction in daytime step count than usual care (p = 0.023), and in night-time step count (p = 0.028) and daytime physical activity (p = 0.026) compared to plush toy group. At post-intervention, the PARO group showed a greater reduction in daytime step count than the plush toy group (p = 0.028), and at night-time compared with both the plush toy group (p = 0.019) and the usual-care group (p = 0.046). The PARO group also had a greater reduction in night-time physical activity than the usual-care group (p = 0.015) | Intrapersonal |
| Nawrat-Szoltysik et al., 2018; Nawrat-Szotysik et al., 2019 [60,61] (Poland) | Four-arm RCT. | Control group (group 1) received only pharmacological treatment. In the other 3 groups, the same drug therapy was enhanced by a program of modified Sinaki exercises (group 2), Nordic walking (group 3), and Sinaki exercises and Nordic walking applied together (group 4) | 91 (91%) | Yamax Digi-Walker pedometers (Yamax Health & Sport Inc., San Antonio, USA) | 81 ( SD 8.25) | Locomotor activity (daily number of steps) improved statistically significantly after intervention in groups 3 (p < 0.000) and 4 (p < 0.000). | Intrapersonal |
| Pomeroy et al., 2011 [72] USA | Quasi-experimental repeated measures; 4-month follow-up | Intervention: nursing home with optimised person-environment (P-E) fit assessed via the housing enabler instrument; control: non-optimised P-E fit nursing home | 29 (93%) | Accelerometer (Actigraph); Physical Activity Survey in Long Term Care (PAS-LTC) | 87 (SD 6.7) | No differences in PA based on PAS-LTC. Non-optimised nursing home had significantly more PA based on activity count (p = 0.003), and step count (p = 0.02). 95% CI not reported. Authors conclude that changing environment alone may not be enough to bring about PA improvements. | Perceived environment |
| Rezola-Pardo et al., 2020 [66] (Spain) | Two arm, single-blinded RCT | Multicomponent exercise program, walking program | 81 (80%) | Actigraph GT3X model, Actigraph LLC, Pensacola, FL, USA | 84 (SD 9.7) | Although both groups showed a trend toward increasing their daily steps (8.7% and 10.9% increases for the multicomponent and walking groups, respectively), the change was not statistically significant. | Intrapersonal; interpersonal |
| Schnelle et al., 2010 [65] (USA) | RCT; PA measured at end of 3-month intervention | Intervention: exercise, choice of snacks, fluid intake; control: usual care | 125 (90%) | Wireless movement device (Augmentech) | 86 (SD 10.0) | Statistically significant increase in PA in intervention group, p < 0.001. 95% CI not reported | Intrapersonal |
| Simmons and Schnelle, 2004 [74] (USA) | Pre-test/post-test; 6-month follow-up | Intervention: Multicomponent Functional incidental training (prompted toileting, encouragement to walk/wheel, repeat sit-to-stands, goal setting, upper body resistance training, fluid intake) | 130 (68%) | Accelerometer (CalTrac); observation | 88.5 (SD 7.1) | Significant improvement in PA in intervention group across both measures of PA, p < 0.01. | Intrapersonal |
CI: confidence interval; MMSE: mini-mental state exam; PAS-LTC: Physical Activity Survey in Long Term Care; PA: physical activity; RAPA: rapid assessment of physical activity; RCT: randomised controlled trial; SD: standard deviation; SE: standard error.